Being Grateful Is Good for Your Health

November 22, Thanksgiving Day in the U.S., is an annual reminder to slow down, take stock and express thanks. Ideally, though, this practice — sans the extravagant multicourse meal — would be a daily one, as the emotion of gratitude has actually been scientifically confirmed to impart some pretty extraordinary health benefits.

While the word "gratitude" can be interpreted in a number of ways depending on context,1 the clinical definition of gratitude is "The appreciation of what is valuable and meaningful to oneself; a general state of thankfulness and/or appreciation."2

In short, it's thankful appreciation for what you have received and/or everything you already have, whether it be tangible or intangible. It's a recognition of the good in life.

The Many Benefits of Gratitude

Dr. P. Murali Doraiswamy,3 an expert in brain and mind health, once said,4 "If [thankfulness] were a drug, it would be the world's best-selling product with a health maintenance indication for every major organ system." Indeed, the fields of psychiatry and primary care are turning out to be tightly intertwined and overlapping,5 as studies have linked the practice of gratitude to:

Reduced stress and emotional distress, in part by improving emotional resiliency6

Improved self-care, such as getting exercise, eating well and getting regular health checkups,10 leading to fewer health complaints and doctor visits11

Aside from its biological effects, gratitude also creates a benevolent ripple effect into other areas of your life, and has been shown to improve your:12,13,14,15

Intimate relationships, generating a greater sense of connectedness and satisfaction as a couple16

Patience, willpower and impulse control, all of which allow you to make better decisions17,18

Mental health, significantly improving symptoms of depression19 and anxiety, increasing joy, sustained happiness, overall life satisfaction and general sense of well-being20 and pleasure21

Ability to overcome the negative effects of materialism and reduce materialistic strivings, which is a well-recognized source of unhappiness and frustration22

Improved work performance (in one study, managers who expressed gratitude saw a 50 percent increase in the employees' performance)

Studies23 have also demonstrated that gratitude exercises such as writing down what you're grateful for and paying-it-forward results in neural changes that create a positive feedback loop, increasing your ability to experience gratitude in the future. In other words, your sense of gratitude is strengthened through the feeling and doing of it.

Gratitude Increases Joy and Builds Sustained Happiness

According to the Harris Poll Happiness Index, only 1 in 3 Americans reports being "very happy." More than half say they're frustrated at or by work.24 Other research suggests nearly 1 in 4 experiences no life enjoyment at all.25

The good news is, small changes in perspective and/or behavior can add up, and practicing gratitude may be at the top of the list of strategies known to boost feelings of joy, ultimately leading to sustained, long-term happiness and life satisfaction. Gratitude is also neutrally linked with generosity,26,27 and as you'd suspect, generosity has been shown to augment happiness as well.

If you're among those who could use a happiness boost, consider cultivating an attitude of gratitude — every day. A simple and proven way of doing this is to keep a gratitude journal, in which you document the things you're grateful for.

In one study,28 participants who kept a gratitude diary and reflected on what they were grateful for just four times a week for three weeks improved their depression, stress and happiness scores. A few tips to consider as you journal:

Focus on the benevolence of other people. Doing so will increase your sense of being supported by life and decrease unnecessary anxiety

Focus on what you have received rather than what's been withheld

Avoid comparing yourself to people you perceive to have more advantages. Doing so will only erode your sense of security

For Well-Being, You Need Three Positive Emotions for Each Negative One

Several other gratitude-strengthening and happiness-boosting practices are listed in the section below. The key is consistency. Find a way to incorporate your chosen method into each week; ideally do it each day, and stick with it. Place a reminder note on your bathroom mirror if you need to, or schedule it into your calendar along with all of your other important to-do's.

Remember, a key feature of gratitude and happiness is to take the time to acknowledge your positive emotions; don't minimize or suppress them. The benefit is in the actual experiencing of the emotion. According to Barbara Fredrickson, a psychologist and positive-emotions researcher, most Americans have two positive experiences for every negative one.

Remarkably, this 2-to-1 positivity ratio is barely enough to keep you going. To actually flourish emotionally, Fredrickson's research29 shows you need a 3-to-1 ratio. This means you need three positive emotions for every negative.

Practical Strategies to Strengthen Gratitude and Boost Happiness

Following are a diverse array of practices, recommended by various experts and researchers, that can boost your gratitude (and happiness) quotient. You can also get more ideas from Robert Emmons' lecture above. Emmons, a professor of psychology at the University of California, is one of the leading scientific experts on gratitude who has written several books on the topic.

For example, one of the things he discusses is the ability to receive. Many of us enjoy gift giving, but respond with anxiety or some other qualitatively negative emotion when we receive gifts. We may worry about the cost, feeling we don't deserve or really need something that expensive, and so on. So, remember, practicing gratitude involves joyous acceptance of the gift.

If you like, conduct your own little experiment: Write down your current level of happiness and life satisfaction on a piece of paper or your annual calendar, using a rating system of zero to 10. Every three months or so (provided you've actually been doing your gratitude exercise), reevaluate and rerank yourself.

Write thank-you notes30 — When thanking someone, remember to be specific; recognize the effort involved and the cost, and focus on the other person, not yourself (see verbal praise). To flex your gratitude muscle, make it a point to write thank-you notes or letters in response to each gift or kind act — or simply as a show of gratitude for someone being in your life.

Give verbal praise and say "thank you" more often — Saying thank you and giving praise is much like the practice above, only verbal. As above, keep the focus on the other person and not yourself, for optimal results.

Research31 shows that using "other-praising" phrases are far more effective than "self-beneficial" phrases. For example, praising a partner saying, "thank you for going out of your way to do this," is more powerful than a compliment framed in terms of how you benefited, such as "it makes me happy when you do that."

Say grace at each meal — Adopting the ritual of saying grace at each meal — and not just over Thanksgiving dinner — is a great way to practice gratitude on a daily basis,32 and will also foster a deeper connection to your food.

While this can be a perfect opportunity to honor a spiritual connection with the divine, you don't have to turn it into a religious speech if you don't want to. You could simply say, "I am grateful for this food, and appreciate all the time and hard work that went into its production, transportation and preparation."

Change your perception — Disappointment — especially if you're frequently struggling with things "not going your way" — can be a major source of stress, which is known to have far-reaching effects on your health and longevity.

In fact, centenarians overwhelmingly cite stress as the most important thing to avoid if you want to live a long and healthy life. Since stress is virtually unavoidable, the key is to develop and strengthen your ability to manage your stress so that it doesn't wear you down over time.

Rather than dwelling on negative events, most centenarians figured out how to let things go, and you can do that too. It takes practice, though. It's a skill that must be honed daily, or however often you're triggered.

A foundational principle to let go of negativity is the realization that the way you feel has little to do with the event itself, and everything to do with your perception of it. Wisdom of the ancients dictates that events are neither good nor bad in and of themselves. It is your belief about the event that upsets you, not the fact that it happened.

As noted by Ryan Holiday, author of "The Daily Stoic: 366 Meditations on Wisdom, Perseverance, and the Art of Living,"33 "The Stoics are saying, 'This happened to me,' is not the same as, 'This happened to me and that's bad.' They're saying if you stop at the first part, you will be much more resilient and much more able to make some good out of anything that happens."

Be mindful of your nonverbal actions — Smiling and hugging are both ways of expressing gratitude, encouragement, excitement, empathy and support. These physical actions also help strengthen your inner experience of positive emotions.

Prayer and/or mindfulness meditation — Expressing thanks during prayer or meditation is another way to cultivate gratitude. Practicing mindfulness means that you're actively paying attention to the moment you're in right now.

A mantra is sometimes used to help maintain focus, but you can also focus on something that you're grateful for, such as a pleasant smell, a cool breeze or a lovely memory.

Create a nightly gratitude ritual — One suggestion is to create a gratitude jar,34 into which the entire family can add notes of gratitude on a daily basis. Any jar or container will do. Simply write a quick note on a small slip of paper and put it into the jar.

Some make an annual (or biannual or even monthly) event out of going through the whole jar, reading each slip out loud. If you have young children, a lovely ritual suggested by Dr. Alison Chen in a Huffington Post article35 is to create a bedtime routine that involves stating what you're grateful for out loud.

Spend money on activities instead of things — According to recent research,36 spending money on experiences not only generates more gratitude than material consumption, it also motivates greater generosity.

As noted by coauthor Amit Kumar, postdoctoral research fellow at the University of Chicago, "People feel fortunate, and because it's a diffuse, untargeted type of gratitude, they're motivated to give back to people in general."37

Embrace the idea of having "enough" — According to many who have embraced a more minimalist lifestyle, the key to happiness is learning to appreciate and be grateful for having "enough." Financial hardship and work stress (to a degree caused by excessive expenditures, necessitating more work to pay the bills) are two significant contributors to depression and anxiety.

The answer is to buy less and appreciate more. Instead of trying to keep up with the Joneses, practice being grateful for the things you already have, and release yourself from the iron-grip of advertising, which tells you there's lack in your life.

Many who have adopted the minimalist lifestyle claim they've been able to reduce the amount of time they have to work to pay their bills, freeing up time for volunteer work, creative pursuits and taking care of their personal health, thereby dramatically raising their happiness and life satisfaction. The key here is deciding what "enough" is. Consumption itself is not the problem; unchecked and unnecessary shopping is.

It's like being on a hamster wheel — you keep shopping, thinking happiness and life satisfaction will come with it. Yet it never does. Many times, accumulation of material goods is a symptom that you may be trying to fill a void in your life, yet that void can never be filled by material things.

More often than not, the void is silently asking for more love, personal connection, or experiences that bring purpose and passionate engagement. So, make an effort to identify your real, authentic emotional and spiritual needs, and then focus on fulfilling those needs in ways that do not involve shopping.

Spend more time in nature — Many will naturally feel more grateful for life when they're more connected to nature. It has a way of putting things into perspective.

Research38 also shows spending time in nature helps reduce rumination (obsessive negative thoughts that go 'round and 'round without ever getting to any kind of resolution). Ruminating thoughts light up a region in your brain called the subgenual prefrontal cortex, an area that regulates negative emotions, and is associated with an increased risk for anxiety and depression.

Other recent research shows that the mere sounds of nature have a distinct effect on your brain, lowering fight-or-flight instincts and activating your rest-and-digest autonomic nervous system.39,40,41 Previous research has also demonstrated that listening to nature sounds help you recover faster after a stressful event.

Try tapping — The Emotional Freedom Techniques (EFT) is a helpful tool for a number of emotional challenges, including lack of gratitude. EFT is a form of psychological acupressure based on the energy meridians used in acupuncture that can quickly restore inner balance and healing, and helps rid your mind of negative thoughts and emotions. In the video below, EFT practitioner Julie Schiffman demonstrates how to tap for gratitude.